About Entyvio (vedolizumab)
Entyvio, an integrin receptor antagonist, is a humanized monoclonal antibody that specifically binds to the alpha4beta7 integrin and blocks the interaction of alpha4beta7 integrin with mucosal addressin cell adhesion molecule-1 (MAdCAM-1) and inhibits the migration of memory T-lymphocytes across the endothelium into inflamed gastrointestinal parenchymal tissue. Entyvio does not bind to or inhibit function of the alpha4beta1 and alpha E beta 7 integrins and does not antagonize the interaction of alpha4 integrins with vascular cell adhesion molecule-1 (VCAM-1). The alpha4beta7 integrin is expressed on the surface of a discrete subset of memory T-lymphocytes that preferentially migrate into the gastrointestinal tract. MAdCAM-1 is mainly expressed on gut endothelial cells and plays a critical role in the homing of T-lymphocytes to gut lymph tissue. The interaction of the alpha4beta7 integrin with MAdCAM-1 has been implicated as an important contributor to the chronic inflammation that is a hallmark of ulcerative colitis and Crohn’s disease.(Reference: Takeda)

People, do you have concerns about PML? Will you order JC virus test? And second question: Will you use immunosuppressants(aza, 6mp, mtx...) to prevent building up antibodies againist vedolizumab?
This article http://www.atmjournal.org/article/view/2931/3851 says:
Immunogenicity was low in the study with only 4% of patients developing antibodies to vedolizumab; further less than 1% developed persistent antibodies.

Will definitely have to do more reading about it if I decide to take it, but not too concerned about PML as from what I have read, there were no cases of it in in the clinical trials that were conducted.

Not sure about concurrent immunosuppressants, either, will definitely read more and ask my doctor what he thinks.

Going tomorrow, and will hopefully get a better answer on when I can start Stelara. Only three weeks since my last Simponi dose, so will still be a while yet, I think.

I am going to start this as soon as my doc can get his hands on it. Has anyone else's Gastro had any trouble actually receiving it from Takeda? I am hoping this will work well for me, because I was on Tysabri, which worked wonderfully, but as I am JCV Positive, I discontinued it after a year. Love to hear about anyone who is having success!

I am setting up an appointment tomorrow for my first Entyvio infusion. I have been dealing with fistulas and inflammation. Really hoping this medication will do the trick. I'm so tired of dealing with these fistulas and the roller-coaster ride that is Crohn's Disease. I will let you all know how the infusion goes and if I have any positive results. I believe my doctor helped with the research for this drug, so she was able to start treating patients with it fairly soon after it was approved by the FDA.

My husband is actually the Crohn's patient. He had horrible side effects after 20 mos. on Remicade. We have an appt. on 7/3 with the GI. He has finally gotten approval from our ins co for Vedo. I feel like I haven't had much time to research but want to be prepared for this visit. What do I need to know? I'm concerned about side effects. My husband has severe Crohn's and has been on Prednisone for 3 mos now to keep him out of the hospital. He has active disease and is struggling through every day. Could this really be our miracle drug?

Hi everyone,
I just had my first entyvio infusion today. I was taking tysabri and my Gi switched me due to losing response. I had about 2 good weeks a month. He hopes entyvio will keep me more stable. So far I have had fatigue, some joint pain and I just noticed I have a rash (I am not itchy but a rash that looks like goose bumps). Other then the rash it is similar side effects as the other biologics. The infusion was quick only a half hour. The iv push is at a fast rate. My insurance took about 2 1/2 weeks. I am lucky to have one of the top doc's in the nation here in Chicago, IL and he had all the proper paperwork ready for patients he was switching. The infusion center I go to said that since he has all of the right paperwork approvals where taking about 2-4 weeks depending on the insurance medical reviewer.
I hope this will work better then tysabri since this targets the gut only. I have failed all other biologics so far so this is my last resort. I am not worried about PML with this med as I continue to text negative for the JC virus and this med is not suppose to pass the the blood brain barrier.
I will get my next infusion in 2 weeks. I will give an update again after that.

Good luck Dee71! I assume you are seeing Dr. Hanauer. I traveled to Chicago a few years ago to see him for advice about Tysabri. Very knowledgeable man! You are lucky to have him as a doctor. There are no Crohn's experts where I live. I also failed the biologics (Remicade almost killed me), and Tysabri lost effect after about a year.

I'm getting my first Entyvio infusion tomorrow, and I'm really excited. Do you know how long it is supposed to take to start working if it is going to help? I think I read somewhere that if it's not helping by about 14 weeks, you should stop. Has anyone else heard this?

Thank you kromom1! I wish you luck too. I hope your infusion goes well! It is short and I didn't have to sit after. I would like to hear how it goes for you. Since they do loading doses I think the norm for these meds to kick in is up to 6 weeks. My dr didn't say anything about stopping after 14 weeks if it doesn't work. He likes to to be on the optimistic side and just has me come back in 3 mons to see how I'm am doing. They are also monitoring blood and stool inflimation markers (those are never very impressive for me even when I'm in a full flare). I actually dr Rubin who is the other top dog at u of c. He is also a great dr. He is the only Gi doc who has not given up on me. I have failed pretty much all the meds on the market so I am really hoping this on works. I have my next infusion on the 19th. I was on remicade for 7 years and it worked great until I developed remicade induced lupus. The joint pain was unbaerable! I have had bad reactions to every thing else and 6mp makes my liver enzymes go through the roof after only a few weeks so that out also.
I am sorry you reacted so badly to remicade! Stay positive, this will be the one!! :-)

Did your Remicade incuded Lupus clear up the longer you were off the Remicade? I developed MS after being on Remicade for 5 years, which COULD have been triggered by the Remicade. Now I am constantly wondering if it will fade away the longer I am off of the Remicade, or if I have MS permanently now...nobody seems to know, not even when I made a trip to the Cleveland Clinic...Still waiting for my insurance approval for Entyvio, and waiting with nervous excitement.

I am so sorry you developed MS! Yes my lupus did go away after going off of remicade, it took a few months. From what I have heard at the crohns and colitis education conferences it is not uncommon to develop more then one autoimmune disease such as MS, RA etc.. I am not sure if the remicade can induce ms? Did they put you on any meds for the MS?
I hope your INS approval for entyvio comes through quick and that it helps your crohns!!

Had my first entyvio infusion yesterday. Infusion only lasted 30 mins,only side effects were some dizziness & fatigue. Fingers crossed it works . Crohns for 38 years, many surgeries, gone through all other meds, currently on TPN.

I am currently taking Copaxone for my MS. I know it may be some wishful thinking, imagining that the MS will "go away" the longer that I am off of the Remicade. But, I haven't had any MS symptoms since my initial diagnosis, and my last MRI was "stable", for what that is worth...

Dee71 - I also developed Remicade-induced lupus (after only the first three infusions). Not a lot of joint pain, but my lungs and heart filled up with fluid, and I had to have pericardial window surgery and was in the ICU for 11 days on a ventilator. The lupus did go away over the next year, but no more Remicade for me! I have also failed pretty much everything else. I was supposed to have my first infusion of Entyvio yesterday, but due to a screw-up in the pharmacy, I had to reschedule until next Monday, 7/14.